HomeMy WebLinkAboutBuilding Permit 99-0284
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
5-~-'1'
cr;~()
ADDRESS
J h 8 '18 W.1it&J J.an",
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING
o FRAMING
. ~..l'ISULATION
pr ~ ~~NAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
COMMENTS: R (2fJI
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
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o EXC/GRAD/FILLING
o LKSHOREnNETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
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X WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CA OR REINSPECTION BEFORE COVERING
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Inspector:
Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99- 264-
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION I
LOT )( /
,
YfllA",OW5
La.;) e-
4-
&Trl
BLOCK
ADDITION
(Name)
New Construction 0
,-:--
.1-~c.
Fireplace 0
Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
12. NO. OF STORIES
PIC
/lOON.
2:;J-Z4t'-032..- 0
(Address)
(Tel. No.)
(Address)
(Tel. No.)
(Tel. No.)
{(p I 2...)
o-~ool
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
Septic 0
Addition 0
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
buildin official can revoke this it for just cause. Furthermore. I hereby agree that the city official or a designee may enter upon the property to perfo,rm yeeded inspections.
X .. 37/2- $I/&/'F?
Signature License No. Date
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
,eE5
/1/ /C?..
.
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Back
Side
SOIL TESTS
o
o ENERGY DATA
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
2- 5tJtJ. tJO
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee .... ... .. . .. .. .. .. .. ... $
Sewer Tap ................................... $
$
'iL/. 75
I. ZS-
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
"'" 7t f/!J "",;~ No :5 -Ie G (,
Issued Date 1 If 1 By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Or'dinan~e and may proceed afrequested_ This document when
signed by the City Planner const~utes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
Gas Fireplace Permit ....................... $
This APPIi~Uilding Permit Wh~roJ:J. '1
By Date 7; '1
Certijicate of Occupancy
City Planner
76.00
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850